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Satisfaction Survey

Page One

This comprehensive survey is designated to assist Kearsley Rehabilitation and Healthcare Center in its efforts to provide the highest possible quality of care to the residents it serves. Not only is the survey helpful in assessing customer satisfaction, your responses will also help the provider determine what you consider important in skilled nursing care. Please take a few minutes to complete this survey. Your opinion is important. Your responses will remain confidential; there is no need to identify yourself by name. Thank you.

FacilityID This question requires a valid number format.

1. Name: (optional)

2. From which hospital were you admitted to our facility?

3. Did the staff maintain a kind, caring and respectful attitude toward residents, family and visitors?

Very Satisfied

Somewhat Satisfied

Somewhat Dissatisfied

Very Dissatisfied

Not applicable

4. Was the staff approachable and responded professionally at all times?

Very Satisfied

Somewhat Satisfied

Somewhat Dissatisfied

Very Dissatisfied

Not applicable

5. Did the staff take your concerns seriously?

Very Satisfied

Somewhat Satisfied

Somewhat Dissatisfied

Very Dissatisfied

Not applicable

6. Did the staff respond adequately to your toileting needs?

Very Satisfied

Somewhat Satisfied

Somewhat Dissatisfied

Very Dissatisfied

Not applicable

7. Were daily tasks such as getting dressed, washed and making your bed completed in a timely fashion?

Very Satisfied

Somewhat Satisfied

Somewhat Dissatisfied

Very Dissatisfied

Not applicable

8. How did you like having the same staff assigned to you on a consistent basis?

Very Satisfied

Somewhat Satisfied

Somewhat Dissatisfied

Very Dissatisfied

Not applicable

9. How satisfied were you with the quality of the food?

Very Satisfied

Somewhat Satisfied

Somewhat Dissatisfied

Very Dissatisfied

Not applicable

10. How satisfied were you with the temperature of the food?

Very Satisfied

Somewhat Satisfied

Somewhat Dissatisfied

Very Dissatisfied

Not applicable

11. How satisfied were you with the diversity of menu choices?

Very Satisfied

Somewhat Satisfied

Somewhat Dissatisfied

Very Dissatisfied

12. Were the activities enjoyable and appropriate for you?

Very Satisfied

Somewhat Satisfied

Somewhat Dissatisfied

Very Dissatisfied

Not applicable

13. Were the therapy staff sensitive to your stamina/physical condition?

Very Satisfied

Somewhat Satisfied

Somewhat Dissatisfied

Very Dissatisfied

14. How satisfied were you with the physician services and were they available to meet your needs and questions?

Very Satisfied

Somewhat Satisfied

Somewhat Dissatisfied

Very Dissatisfied

Not applicable

15. Did your doctor respond when you or your family called for assistance?